Koben Jackson

NPI 1972767317 · on the registry since 2008 · sole proprietor

Practice

Address: 8502 Edgemere Rd
Dallas, TX 75225
Phone: (214) 369-7995
Organisation at this address: Rehabcare
Bay 9 Holdings Llc
Northwest Senior Housing Corporation
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 16

Registry record

Primary taxonomy: Physical Therapist
225100000X
Licence states on file: TX
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2008-07-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas